An exceptional situation, exceptional measure. In Peru, “the national level health emergency is declared for 90 days, due to the unusual increase in cases of Guillain-Barré syndrome” (GBS), the Peruvian Ministry of Health said in a press release. The 25 regions of this country of 33 million inhabitants are concerned.
“There has been a significant increase in recent weeks that obliges us to take measures at state level to protect the health and life of the population,” Health Minister César Vásquez told the press. Why such a situation ? We explain to you.
Where is the disease in Peru?
Between January and July, Peru recorded more than 180 cases of the syndrome, which caused four deaths, according to a latest report from the ministry.
This is not the first time that the country has been confronted with this disease. In 2019, health authorities counted 507 cases of GBS in June, including 301 cases during the week of June 3-9 alone. The Peruvian Ministry of Health then declared a state of emergency in five regions. However, the cause of this explosion of cases had not been identified. And a year earlier, the Peruvian health authorities recorded 215 cases and an epidemic center in the region of Trujillo, the third largest city in the country.
What are the symptoms of the disease, and is there a treatment?
With GBS, “the patient’s immune system attacks part of the peripheral nervous system,” explains the World Health Organization (WHO). This syndrome is characterized by neurological involvement, also called acute polyradiculoneuritis, which manifests as progressive muscle weakness that occurs over two to four weeks and can affect the respiratory system. One of its most common symptoms is tingling and lack of strength in the extremities.
“In some subjects, these symptoms can progress to paralysis of the legs, arms or facial muscles. In 20% to 30% of patients, there is damage to the thoracic muscles, making breathing difficult, details the WHO. In severe cases, the ability to speak and swallow may be affected. These cases (…) must be treated in intensive care units. And even in the best health settings, 3% to 5% of GBS patients die from complications, such as paralysis of the muscles of respiration, sepsis, pulmonary embolism or cardiac arrest. “.
More often than not, most sufferers make a full recovery, even in the most severe cases, although weakness may persist in some. To date, there is no vaccine or curative treatment, “but the therapies available can relieve the symptoms and reduce the duration of the disease”, completes the WHO. In Peru, the declaration of a health emergency will thus make it possible to purchase immunoglobulin for the treatment of affected patients, for the next two years.
How is GBS contracted and should we fear a resurgence of the syndrome in France?
“Guillain-Barré syndrome is often triggered by an infection – bacterial or viral – or more rarely by vaccination or surgery,” says the WHO. In countries affected by Zika virus infection, there has been an unexpected increase in the number of GBS cases. The most likely explanation (…) is that Zika virus infection is a trigger”.
“Some cases of post-infectious neurological complications [de Zika], of the Guillain-Barré syndrome type, have been observed in French Polynesia ”, after the Zika epidemic which raged in 2013 and 2014, recalls the Institut Pasteur. But at the time, the causal link was not established. It will be demonstrated in 2016 by a team of French researchers coordinated by Professor Arnaud Fontanet, head of the Epidemiology of Emerging Diseases Unit at the Institut Pasteur, in a study published in the journal The Lancet. “This work is important because it makes it possible to confirm the role of Zika virus infection at the origin of these serious neurological complications that are Guillain-Barré syndromes, commented Professor Fontanet at the time. This means that the regions affected by the Zika epidemic must expect a significant increase in the number of patients with serious neurological disorders, and anticipate the reception of these patients in intensive care when it is possible to do so”.
In addition to Zika, “the flu is considered to be one of the possible risk factors for Guillain-Barré Syndrome, adds the Ministry of Health. Few epidemiological data are available on the association between influenza infection and GBS, but most showed that the number of hospitalizations for GBS increased in parallel with the number of observed influenzas”. In France, specifies the ministry, “it is estimated that 1,700 patients are hospitalized each year for GBS”.